Hello. I need spreader grafts in a revision rhino to correct a pinched middle third and breathing issues. My question is regarding the use of Helix cartilage for a spreader graft. I have Scafoid Ear deformity and my helix is flat. since this cartilage in my case is flat and straight, but very soft and pliable, is it vaible to use as spreader grafts? I have asked several questions and I am not sure how to thank all those Dr's who have answered. So, to those who have helped me, THANK YOU
Spreader Grafts Using Helix Ear Cartilage. Is It Possible? (photo)
Doctor Answers 8
Ear Conchal Cartilage For Spreader Grafts If Septum Not Available
Thank you for your question. Spreader grafts to correct the internal nasal valve obstruction or pinching of the middle third of the nose after rhinoplasty is best done using nasal septal cartilage. The nasal septal cartilage is stiffer and thus works better as a spreader graft.
However if you do not have nasal septal cartilage due to a previous septal rhinoplasty then ear cartilage would be the second choice.
From your photographs it appears that you have adequate conchal cartilage to use as a graft and conchal cartilage would be my choice to use as spreader grafts. Helical cartilage is not as stiff as conchal cartilage and harvesting helical cartilage would likely produce a deformity which would be visible.
Spreader grafts and nasal width
Spreader grafts are usually harvested from the septum. However if this is a secondary rhinoplasty and the septum is not available, ear cartilage is ok.
Spreader grafts for rhinoplasty reconstruction
The best cartilage used for spreader grafting purposes is harvested from inside the nose. Only if the nose has been depleted of cartilage, then your surgeon would consider using your ear cartilage. When we use ear cartilage we tend to use the conchal bowl, so as not to leave a deformity in the ear.
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Spreader Grafts using ear cartilage
While it is possible to use helix cartilage for a spreader graft, it would be more advisable to use conchal ear cartilage grafts to avoid any deformity in the ear or cartilage from your septum. Please consult with a head and neck surgery or head and neck trained facial plastic surgeon who can help improve the breathing in your nose that you seek.
generally for this type of problem the cartilage is harvested from the cymba and cavum concha which should not affect your ear. If there is concern about it being to soft it can be supported during the healing process with a PDS plate.
Scaphoid cartilage Spreader Grafts?
Although scaphoid fossa or anterior helical crus cartilage are not generally used as forms of graft material in Rhinoplasty, they can be used as composite skin-cartilage grafts in nasal reconstruction. Briefly put, this is technique could be employed as long as you understand a secondary deformity will likely be created. The extent of this deformity and its aesthetic acceptability might be worthwhile in this particular case, but I would still favor other cartilage sources.
Ear cartilage in revision rhinoplasty
Ear cartilage can be used as spreader grafts when trying to widen the middle third of a stable nose. It is often too weak, however, for more complex revision cases where stability is needed. Ear cartilage is always harvested from the conchal bowl so that no visible deformity remains. Harvesting ear cartilage from the helix or scaphoid fossa could leave a severe deformity.